Why It Is Used

Inhaled corticosteroids may be used to treat stable symptoms
of COPD or symptoms that are slowly getting worse. Inhaled corticosteroids may
decrease the number of COPD exacerbations in people with severe COPD,
particularly those with
chronic bronchitis and frequent exacerbations.

Corticosteroids may be useful for people who have
asthma as a component of their disease.

How Well It Works

Research results on oral corticosteroids for COPD exacerbations show that:

They improve lung function, reduce the amount
of time in the hospital, and reduce the incidence of treatment failure (return
to the hospital, death, or the need for a tube inserted through the mouth or
nose and into the chest to deliver oxygen [endotracheal intubation]).1

Research on inhaled
corticosteroids:

Suggests that for some people they reduce the
frequency of COPD exacerbations compared to a
placebo.2, 3

Combining a corticosteroid with a beta2-agonist and an
anticholinergic improved:7

Lung function.

Quality of life.

The
number of hospital visits.

But people who used fluticasone combined with a
beta2-agonist were more likely to get
pneumonia.7

It is not possible to predict who will improve
with corticosteroid therapy. Lung function tests (spirometry) can
be done before and after using the medicine, to learn if it has helped.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

Usually the benefits of the medicine are more important than any minor side effects.

Side effects may go away after you take the medicine for a while.

If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

The possibility of side effects
increases as the dose of the medicine increases. Side effects are less likely
to occur when you use the inhaled form of the medicine.

Oral corticosteroids (short-term use)

Oral corticosteroids also may increase blood sugar level,
which may lead to a type of diabetes caused by the medicine (secondary diabetes). If you already have diabetes, it
may make the diabetes harder to control.

Inhaled steroids

Growth of a
fungus in the mouth, throat, or
esophagus (thrush). This usually occurs only at high doses.

The U.S. Food and Drug Administration (FDA) has
reported that salmeterol may make breathing more difficult. If your wheezing
gets worse after taking salmeterol, call your doctor right
away.

Using a device called a
spacer with your metered-dose inhaler and rinsing your
mouth with water and spitting the water out after inhaling should reduce these
side effects.

See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)

What To Think About

Inhaled corticosteroids are
preferred to oral corticosteroids for long-term treatment of COPD, because they
cause fewer side effects. But low-dose inhaled steroids do not always work as
well as high-dose oral steroids.

Long-term treatment with oral
corticosteroids is not recommended.8 Although
long-term treatment with inhaled corticosteroids reduces the frequency of COPD
exacerbations in some people, the long-term risks and whether the benefit is
worth the risks of long-term treatment is not known.2

Most doctors recommend that everyone using an inhaler also use a
spacer. Use of a spacer is especially important when
using an inhaler containing a steroid medicine. But you should not use a spacer with a dry
powder inhaler (DPI).

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.